Field Instructor Confirmation of Internship Arrangements for 2nd Year Placement To: Susan Elswick EdD, LMSW, LSSW Director of MSW Field Placement Department of Social Work Re: Field Placement Intern From: ___________________________ Agency: _________________________ I have met with _____________________ to confirm her/him engaging in field placement at this agency for the next academic year. We have discussed the placement and everything that the student will need to do in order to be ready to start placement as soon as school begins in the fall. We have mutually agreed that the student is to begin the placement as of the following date and time: ___________________________, and that her/his field instructor will be ______________________________. I have instructed the student to report to the office located at _____________________________ on the first day of placement. In order that there will be no delay in the student starting on that date, s/he must take care of the following matters beforehand (e.g. background check, physical exam and/or TB test, orientation, etc): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________ (Signature) ___________________ (Date) Please return this notice to the Director of Graduate Field Placement selswick@memphis.edu or By fax at: 678-2981, or By mail at: The University of Memphis, 226 McCord Hall, Memphis, TN 38152